Adding mindfulness practice to standard pharmacological treatment for chronic migraine with medication overuse headache led to a significant reduction in headache frequency after one year, while standard treatment alone did not. Mindfulness patients also showed greater functional connectivity between the salience network and the left posterior insula and sensorimotor cortex, increased cortical thickness in the insula and anterior cingulate cortex, and a link between stronger insula-salience network connectivity and improved depression scores. These brain changes may help explain how mindfulness improves pain management and emotional regulation in this condition.
Ergotamine, a drug used for cluster headache and migraine, amplifies the amplitude of circadian clock gene expression in mouse fibroblast cells and trigeminal ganglion explants without altering period length. This effect appears to be mediated through serotonin 1D and 2C receptors. In a mouse model of chronic headache, ergotamine raised hindpaw pain thresholds when administered during the daytime (ZT4) but not at night (ZT16), suggesting a chronotherapeutic benefit. The findings indicate that ergotamine's efficacy may vary with time of day, providing a rationale for timed dosing in migraine treatment.